Ceccaldi P-F, Ferreira C, Coussy F, Mechler C, Meier F, Crenn-Hebert C, Mandelbrot L
Service de gynécologie-obstétrique, hôpital Louis-Mourier, AP-HP, université Paris-7, 178, rue des Renouillers, 92700 Colombes, France.
J Gynecol Obstet Biol Reprod (Paris). 2010 Oct;39(6):466-70. doi: 10.1016/j.jgyn.2010.06.009. Epub 2010 Aug 6.
An increasing number of HIV-1-infected women reaches the age of menopause. This infection is associated with a higher incidence of cervical squamous intraepithelial lesions (low-grade or LSIL, high grade or HSIL). The aim of our study was to describe the cervical disease in these patients during menopause.
Retrospective study, identifying all Pap smears and colposcopy in HIV-1-infected postmenopausal women between 1995 and 2008, in our hospital.
Eighteen postmenopausal women, aged of 54 years (43-63), have HIV-1 infection since 7.5 years (2-25). Fifty-one pathological exams were reviewed in which 27 (50.98%) abnormal, including four (7.84%) ASC-US, 15 (29.41%) LSIL lesions, and seven (13.73%) HSIL. Ten patients had surgery (laser, conisation, hysterectomy) during the period. The evolution of cervical lesions was: stability in 40.48%, regression in 35.71% and progression in 23.81%. The median time to develop an HSIL at menopause was 5 years.
In our study, postmenopausal HIV-1-infected women have most frequently LSIL and persistent. Monitoring of these postmenopausal women should be continued, the attitude to realise an initial HPV typing and confirmation of an abnormal annually Pap smear with colposcopic exam should be confirmed by larger study.
越来越多感染人类免疫缺陷病毒1型（HIV-1）的女性进入更年期。这种感染与宫颈鳞状上皮内病变（低级别或LSIL，高级别或HSIL）的较高发病率相关。我们研究的目的是描述这些患者在更年期期间的宫颈疾病情况。
回顾性研究，确定我院1995年至2008年间HIV-1感染的绝经后女性的所有巴氏涂片和阴道镜检查情况。
18名绝经后女性，年龄54岁（43 - 63岁），感染HIV-1达7.5年（2 - 25年）。共审查了51份病理检查报告，其中27份（50.98%）异常，包括4份（7.84%）意义不明确的非典型鳞状细胞（ASC-US）、15份（29.41%）LSIL病变和7份（13.73%）HSIL。在此期间，10名患者接受了手术（激光、锥切术、子宫切除术）。宫颈病变的演变情况为：40.48%稳定，35.71%消退，23.81%进展。更年期出现HSIL的中位时间为5年。
在我们的研究中，感染HIV-1的绝经后女性最常见的是LSIL且病变持续存在。应继续对这些绝经后女性进行监测，对于进行初始人乳头瘤病毒（HPV）分型以及每年通过阴道镜检查确认巴氏涂片异常的态度，应通过更大规模的研究加以证实。
